Abstract: :
Purpose: To report ultrasound abnormalities and their incidencein eyes with endophthalmitisMethods: We reviewed the recordsof 70 consecutive patients with the clinical diagnosis of endopthalmitiswho underwent ultrasound evaluation at the MEEI from 1999-2002.Preoperative ultrasounds of 6 patients with dense cataractswere used as controls. Sonographic findings evaluated includedthe density of vitreous and membranous debris, retinal and choroidaldetachments; macular edema, disc edema, choroidal thickening,and the presence of sub-Tenon's fluid. Vitreous debris was gradedas 1, 2, or 3 if less than 10%, between 10-50%, or greater than50% of the vitreous cavity was involved.Results: Fifty-fourpatients met inclusion criteria. The most common causative organismwas coagulase-negative Staphylococcus (N=17, 31.5%). 5.6% ofeyes had initial visual acuities of 20/50-20/200, 33 (61.1%)had acuities of 19/200 to hand movements, and 13 (24.1%) werelight perception or worse. Ultrasound findings of only moderatevitreous debris was seen in 14.8% of eyes with endophthalmitis.Severe vitreous debris (grade 3) was detected in 70.4% of eyeswith endophthalmitis vs. 0% of controls. Loculated pockets ofdebris were common in patients with endophthalmitis (36%) andwas membranous in 70.4% of eyes. Macular edema and disc edemawere seen in 16.7% and 7.4% of eyes with endophthalmitis. Choroidalthickening was observed in 16.7% of eyes while choroidal andretinal detachments were present in 14.8% and 7.4% of eyes withendophthalmitis. Fluid in sub-Tenon's space was detected in13% of eyes.Conclusions: Predominant ultrasound findings ineyes with endophthalmitis are: 1) severe levels of vitreousdebris, 2) moderate and severe membranous debris, and 3) loculatedpockets of vitreous debris. These findings were not found incontrol eyes. We also found that detachments of the retina orchoroid are present in more than one-fifth of all patients withendophthalmitis. Less common findings include macular edema,disc edema, choroidal thickening, and sub-Tenon's fluid. Thesefindings support the use of ultrasonography as an importantclinical aid in the diagnosis and management of endophthalmitis.Future prospective studies may help define which of these ultrasoundfindings are important prognostic indicators.